Polyarthritis presented in a patient with untreated chronic hepatitis B infection.

Abstract

Hepatitis B virus (HBV) infection can cause arthritis, but it is rarely reported. In the current report, we present a case of chronic polyarthritis in a patient with untreated HBV infection. A 63-year-old woman suffering from polyarthritis in her fingers visited our institution. She had experienced exacerbations and remissions of polyarthritis for more than 20 years. She had been diagnosed with rheumatoid arthritis and had been treated with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) and nonsteroidal anti-inflammatory drugs by her primary care doctor, but the csDMARDs were discontinued at the request of the patient 10 years before the first visit to our hospital. The blood test showed negative for rheumatoid factor and anticyclic citrullinated peptides antibody but positive for hepatitis B surface antigen. Hepatitis B surface antigen and HBV-Deoxyribo Nucleic Acid (DNA) were increased to 312.6 (IU/ml) and 4.6 (log copies/ml), respectively. Based on the results of abdominal computed tomography and echography, she was diagnosed with liver cirrhosis. Treatment for HBV infection was begun with oral tenofovir at 25 mg/day. The polyarthritis in her fingers gradually disappeared and has not relapsed for 6 months after the initiation of treatment for HBV infection. When polyarthritis is diagnosed, the possibility that chronic HBV infection can be one of the causes of polyarthritis should be considered.

• Authors: Kenichi Kikuchi, Koji Fukuda, Shinya Hayashi, Toshihisa Maeda, Yoshinori Takashima, Masahiro Fujita, Kenmei Ikuta, Kensuke Anjiki, Shotaro Tachibana, Yuma Onoi, Tomoyuki Matsumoto, Ryosuke Kuroda, Tsukasa Matsubara
• Journal: Modern rheumatology case reports (Mod Rheumatol Case Rep) Vol. 7 Issue 1 Pg. 320-323 (01 03 2023) ISSN: 2472-5625 [Electronic] England
• PMID: 36214605 (Publication Type: Case Reports, Journal Article)
• Copyright: © Japan College of Rheumatology 2022. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: [email protected].

Chemical References

• Hepatitis B Surface Antigens
• Hepatitis B Antibodies
• Antirheumatic Agents

Topics

• Female
• Humans
• Middle Aged
• Hepatitis B, Chronic (complications, diagnosis, drug therapy)
• Hepatitis B Surface Antigens (therapeutic use)
• Hepatitis B Antibodies (therapeutic use)
• Hepatitis B (diagnosis, drug therapy)
• Hepatitis B virus (genetics)
• Arthritis, Rheumatoid (drug therapy)
• Antirheumatic Agents (therapeutic use)